Local cardiologist corrects defect without open heart surgery

KINGSPORT — A Kingsport cardiologist performed a state-of-the-art procedure Tuesday to close a hole in the heart of a 34-year-old woman without open heart surgery.

The procedure was a first for the Tri-Cities, according to Dr. Marc Mayhew and officials with Wellmont Health System. It closed a hole between the two heart chambers.

The procedure was done at Wellmont’s Holston Valley Medical Center. Mayhew, a board-certified cardiologist with Cardiovascular Associates, said the surgery went fine, and the patient is expected to return home today.

In the procedure, Mayhew implanted a small mesh disc filled with polyester fabric called an Amplatzer septal occluder. The disc is inserted through a catheter similar to the kind used during a cardiac catheterization.

Mayhew said the disc is tailored to the specific hole, based on its size, shape and position as determined by an ultrasound.

Mayhew said the woman had a genetic anomaly called a patent foramen ovale, a hole in the wall between the two heart chambers.

All infants are born with a foramen ovale that usually closes at birth, but the hole does not close in about 25 percent of the population. Some people live with a PFO and suffer no serious ill effects. Mayhew said patients with concerns about the condition should consult with their doctors.

“Just because one in four people out there has this doesn’t mean I need to close every one of those,” Mayhew said.

He said those identified with the condition but not candidates for surgery are, among other things, told not to scuba dive.

“The advice not to scuba dive is a good one,” Mayhew said, explaining that the condition combined with scuba diving can cause the bends, otherwise known as decompression sickness.

Mayhew said Tuesday’s procedure was warranted because the patient suffered a stroke this summer because of her condition. Because she is of child-bearing age, in case of pregnancy she cannot use blood thinners that otherwise would be used to treat her.

Mayhew said the woman and her doctors did not realize her condition until diagnostics done after the stroke.

“Most people don’t know,” Mayhew said. “Twenty-five percent of the adult population has this condition. Normally it doesn’t cause a problem.”

In the woman’s case, Mayhew said a blood clot likely crossed from the right to left side of the heart and then made its way to the brain, causing a stoke.

Less likely but possible are clots moving from the right to left and then getting into a heart artery, causing a heart attack.

Holston Valley has been recognized by Thomson Reuters as one of America’s Top 100 heart hospitals two of the past four years, based on patient outcomes. The hospital serves as a tertiary referral center for Wellmont’s System’s Regional Heartcare Network.